Single nucleotide polymorphisms and Zn transport by ZIP11 shape functional phenotypes of HeLa cells.

Zinc (Zn) is a vital micronutrient with essential roles in biological processes like enzyme function, gene expression, and cell signaling. Disruptions in the cellular regulation of Zn2+ ions often lead to pathological states. Mammalian Zn transporters, such as ZIP11, play a key role in homeostasis of this ion. ZIP11 resides predominately in the nucleus and Golgi apparatus. Our laboratory reported a function of ZIP11 in maintaining nuclear Zn levels in HeLa cervical cancer cells. Analyses of cervical and ovarian cancer patients' datasets identified four coding, single nucleotide polymorphisms (SNPs) in SLC39A11, the gene that encodes ZIP11, correlating with disease severity. We hypothesized that these SNPs might translate to functional changes in the ZIP11 protein by modifying access to substrate availability. We also proposed that a metal-binding site (MBS) in ZIP11 is crucial for transmembrane Zn2+ transport and required for maintenance of various pathogenic phenotypes observed in HeLa cells. Here, we investigated these claims by re-introducing single the SLC39A11 gene encoding for mutant residues associated with the SNPs, as well as MBS mutations into HeLa cells knocked down for the transporter. Some SNPs-encoding ZIP11 variants rescued Zn levels, proliferation, migration, and invasiveness of knockdown (KD) cells. Conversely, single MBS mutations mimicked the traits of KD cells, confirming the transporter's role in establishing and maintaining proliferative, migratory, and invasive traits. Overall, the intricate role of Zn in cellular dynamics and cancer progression underscores the significance of Zn transporters like ZIP11 in potential therapeutic interventions.

Dim Light at Night Promotes Circadian Disruption in Female Rats, at the Metabolic, Reproductive, and Behavioral Level.

Inhabitants of urban areas are constantly exposed to light at night, which is an important environmental factor leading to circadian disruption. Streetlights filtering light through the windows and night dim light lamps are common sources of dim light at night (DLAN). The female population is susceptible to circadian disruption. The present study is aimed to determine the impact of DLAN on female Wistar rats circadian rhythms, metabolism, reproductive physiology, and behavior. After 5 weeks of DLAN exposure daily, oscillations in activity and body temperature of female rats are abolished. DLAN also decreases nocturnal food ingestion, which results in a diminishment in total food consumption. These alterations in the temporal organization of the body are associated with a significant decrease in melatonin plasmatic levels, reproductive disruptions, decreased exploration times, and marked anhedonia. This study highlights the importance of avoiding exposure to light at night, even at low intensities, to maintain the circadian organization of physiology, and denotes the great necessity of increasing the studies in females since the sexual dimorphism within the effects of desynchronizing protocols has been poorly studied.

Violencia estructural, mujeres y conductas disruptivas en San Luis Potosí, México / Structural violence, women and disruptive behaviors in San Luis Potosi, Mexico / Violência estrutural, mulheres e comportamentos perturbadores em San Luis Potosí, México

El objetivo de esta investigación fue describir la violencia estructural en la que se desarrollan las conductas disruptivas enfatizando el contexto en el que se genera el aprendizaje social de las mismas, la forma en que se construye la sociedad favoreciendo el ejercicio y prácticas de violencia que afectan a la mujer y a las personas que se desenvuelven en México. Método: 489 personas contestaron la Escala de Conductas Disruptivas en adultos; 21 de las mujeres que alguna vez fueron detenidas. Resultados: se encontró un tamaño del efecto alto en conductas disruptivas en aquellas personas que se juntaron con pandillas, el doble de consumo de sustancias psicoactivas en hombres en contraste con mujeres, así como mayores conductas disruptivas en quienes consumen sustancias ilegales o alcohol, también, el consumo de drogas y alcohol, así como la violencia vivida en la infancia presentan diferencias significativas en mujeres que han sido detenidas y aquellas que no. Discusión: los modelos de socialización, la violencia directa y estructural y la cultura de la violencia aterrizada en el contexto social mexicano generan que tanto hombres como mujeres delincan; la generación de políticas públicas y el desafío a los roles de género tradicionales pueden ser elementos protectores.

The objective of this research was to describe the structural violence in which disruptive behaviors are developed, emphasizing the context in which the social learning of these behaviors is generated, the way in which society is constructed favoring the exercise and practices of violence that affect women and people in Mexico. Method: 489 people answered the Scale of Disruptive Behavior in Adults; 21 of the women who had ever been arrested. Results: we found a high effect size in disruptive behaviors in those who joined gangs, twice the consumption of psychoactive substances in men in contrast to women, as well as greater disruptive behaviors in those who consume illegal substances or alcohol, also, the consumption of drugs and alcohol, as well as violence experienced in childhood show significant differences in women who have been arrested and those who have not. Discussion: socialization models, direct and structural violence and the culture of violence in the Mexican social context cause both men and women to commit crimes; the generation of public policies and the challenge to traditional gender roles may be protective elements.

O objetivo desta pesquisa foi descrever a violência estrutural na qual os comportamentos perturbadores são desenvolvidos, enfatizando o contexto no qual o aprendizado social destes comportamentos é gerado, a forma como a sociedade é construída favorecendo o exercício e as práticas de violência que afetam as mulheres e as pessoas no México. Método: 489 pessoas responderam à Escala de Comportamentos Perturbadores em Adultos; 21 das mulheres já haviam sido presas. Resultados: encontramos um tamanho de efeito elevado para comportamentos perturbadores naqueles que aderiram a gangues, o dobro do uso de substâncias psicoativas em homens do que em mulheres, assim como comportamentos mais perturbadores naqueles que usam substâncias ilegais ou álcool, também, o uso de drogas e álcool, assim como a violência experimentada na infância mostram diferenças significativas nas mulheres que foram presas e naquelas que não o foram. Discussão: modelos de socialização, violência direta e estrutural e a cultura da violência no contexto social mexicano levam homens e mulheres a cometer crimes; a geração de políticas públicas e o desafio aos papéis tradicionais de gênero podem ser elementos protetores.

Características del uso de tratamiento alternativo y complementario en dismenorrea en mujeres en edad fértil / Characteristics of the use of alternative and complementary treatment in dysmenorrhea in women of fertile age

Objetivo: Describir las características del uso de tratamiento alternativo y complementario en dismenorrea en mujeres en edad fértil de una ciudad del norte de Perú. El estudio: Estudio trasversal analítico en mujeres en edad fértil en Mórrope, Lambayeque. Previa capacitación sobre dismenorrea y principales variables. Se entrevistó a 336 mujeres en sus domicilios previa aceptación de consentimiento informado. Hallazgos: Predominó en población estudiada el grupo etario de 15 a 35 años con 83,92% (n=282), con educación secundaria el 57,14% (n=192), más del 90% tenían estrato socioeconómico inferior/marginal. Referente a la dismenorrea, se encontró más del 30% con dolor severo/insoportable, cuyo tratamiento principal fue la MAC con 82,1%(n=220). Las plantas fueron la principal MAC, hallando solamente asociación de uso de MAC con la variable religión (p=0,023). Conclusiones: Las mujeres en edad fértil emplean notoriamente la MAC, como la fitoterapia, como tratamiento de dismenorrea a pesar de no encuentran alivio.

Objetive:To describe the characteristics of the use of alternative and complementary treatment in dysmenorrhea in women of childbearing age in a city in northern Peru. Cross-sectional analytical study in women of The study:childbearing age in Mórrope, Lambayeque. Prior training on dysmenorrhea and main variables. 336 women were interviewed in their homes after accepting informed consent. The age group of 15 to 35 years prevailed in the Findings:studied population with 83.92% (n=282), with secondary education 57.14% (n=192), more than 90% had lower/marginal socioeconomic status. Regarding dysmenorrhea, more than 30% were found to have severe/unbearable pain, whose main treatment was MAC with 82.1% (n=220). Plants were the main MAC, only finding an association of MAC use with the religion variable (p=0.023). Conclusions:Women of childbearing age notoriously use CAM, such as phytotherapy, as a treatment for dysmenorrhea despite not finding relief

Síndrome poliuria - polidipsia de causa autoinmune en el posparto de una mujer de 27 años

La hipofisitis autoinmune es un cuadro caracterizado por la infiltración linfocítica de la hipófisis que produce deficiencia de una o más hormonas, tanto de la adenohipófisis como de la neurohipófisis. Para el diagnóstico, es necesario un alto índice de sospecha, más aún considerando la relación temporal con el embarazoo el parto. Las características clínicas e imagenológicas sugieren el diagnóstico. A pesar que el diagnóstico definitivo es por biopsia, esta no se suele realizar por los potenciales efectos adversos del procedimiento. Presentamos un caso que describe la forma de manifestación de la enfermedad y las características imagenológicas típicas en la resonancia magnética nuclear.

Autoimmune hypophysitis is a condition characterized by lymphocytic infiltration of the pituitary resulting in deficiency of one or more hormones of both the adenohypophysis and the neurohypophysis. For diagnosis, a high index of suspicion is necessary, even more so considering the temporal relationship with pregnancy or childbirth. Clinical and imaging features are suggestive of the diagnosis. Although the definitive diagnosis is by biopsy, this is not usually performed because of the potential adverse effects of the procedure. We present a case describing the form of manifestation of the disease and the typical imaging features on magnetic resonance imaging.

The presence of herpes simplex-1 and varicella zoster viruses is not related with clinical outcome of Bell's Palsy.

Bell's Palsy is the most frequent acute neuropathy of cranial nerves; it has been associated in various reports to herpes viruses. In a prospective study we searched the presence of DNA from five herpes viruses (HSV-1 and 2, VZV, EBV and HHV-6) in 79 patients at the acute phase of Bell's Palsy. Results were related with various parameters; age, gender and clinical outcome. We found the significant presence (p˂0.001) of HSV-1 and VZV in 39% and 42% of patients. However, a large percentage of cases were negative. When comparisons were made between subgroups according to gender and age no differences were found with viral findings nor with clinical outcome of palsy, which was of clinical remission in most cases (78%). Our results suggest that herpes viruses might participate in the complex mechanisms of autoimmunity of Bell's Palsy but not as determinant etiological element.

Nebulización térmica intradomiciliar de la mezcla de flupyradifurona y transflutrina en mosquitos Aedes aegypti susceptibles y resistentes a piretroides en el Sur de México / Indoor thermal fogging of the mixture of flupyradifurone and transflutrin on Aedes aegypti mosquitoes susceptible and resistant to pyrethroids in southern Mexico

Resumen: Objetivo: Evaluar la efectividad de la mezcla de flupyradifurona 26.3 g/L y transflutrina 52.5 g/L aplicada como niebla térmica a mosquitos Aedes vectores de virus dengue, Zika y chikungunya. Material y métodos: Se colocaron grupos de 15 mosquitos de Ae. aegypti (susceptibles y resistentes a piretroides) dentro de jaulas, en sala, recámara y cocina. Posteriormente, se aplicó la mezcla de flupyradifurona y transflutrina dentro de las viviendas a una dosis de 2 y 4 mg/m3, respectivamente. Resultados: La mezcla de flupyradifurona y transflutrina causó mortalidades de 97 a 100% sobre las cepas de mosquitos Aedes y su efectividad fue la misma en los diferentes compartimentos de las viviendas. Conclusiones: La mezcla de flupyradifurona y transflutrina, aplicada en niebla térmica, es una herramienta prometedora para el control de poblaciones de mosquitos Aedes independientemente de su estado de resistencia a insecticidas.

Abstract: Objective: To evaluate the efficacy of thermal fogging of a mixture of flupyrafirudone (26.3 g/L) and transfluthrin (52.5 g/L) against dengue, Zika y chikungunya Aedes mosquito vectors. Materials and methods: Groups of 15 caged Ae. aegypti (susceptible and pyrethroid resistant) mosquitoes were placed in living room, kitchen and bedroom inside houses, after which a dose of 2 and 4 mg/m3 of flupyradifurone and transfluthrine, respectively, was applied as thermal fog. After one hour of exposure mosquitoes were transferred to the laboratory and mortality was recorded after 24 h. Results: The mixture killed 97 to 100% of mosquitoes from the strains and the efficacy was similar independently of their place within the premises. Conclusions: The mixture of flupyrafirudone and transfluthrin applied as thermal fog is a promising tool to control Aedes mosquito populations independently of the pyrethroid-insecticide resistance status.

The Effect of Hurricane Maria on the Surgical Workload of the UPR-affiliated Hospitals.

OBJECTIVE: The Caribbean islands are regularly affected by hurricanes in a seasonal manner, but major (category 4 and 5) hurricanes are infrequent, and what happens in their aftermath is important for future planning. METHODS: We reviewed the surgical cases entered into the University of Puerto Rico (UPR) General Surgery Department database from January 1, 2016, through December 31, 2017. This database collects patient and procedural information from the surgical services of the UPR-affiliated hospitals. To analyze the impact that Hurricane Maria had on the surgical population, we compared cases per month using September 2017 (the month that Maria struck Puerto Rico) as the reference month. A chi-square goodness-of-fit test was used to evaluate differences between months. RESULTS: Information was available for 9,059 cases during the study period. The mean age of the group was 49±14 years, the gender distribution being 56% women, 44% men. The study found a statistically significant difference (p<0.001) in the number of surgical cases per month, with fewer patients in September 2017 (n = 210) compared to other months, representing a 57% decline in the number of cases. These patients tended to be sicker, with an increase in the number who had an American Society of Anesthesiologists physical status classification of 3 or greater. Within 3 months after the natural disaster, the volume of patients started to return to normal. CONCLUSION: We found that this major hurricane resulted in a decreased surgical workload, mostly because elective surgery cases were fewer, but that the patients that came for surgical care tended to be sicker and had, for the most part, poorly controlled systemic diseases. The volume of surgical cases did not reach normal levels until 3 months after the natural disaster.

Herpes viruses in optic neuritis: Similar to Bell's palsy.

OBJECTIVE: Optic Neuritis (ON) might unfold either as a single intracranial neuritis or as multiple sclerosis, a widespread demyelinating disorder. Different herpes viruses have been proposed as potential participants in the etiology of multiple sclerosis (MS). To analyze the potential presence of herpes viruses in blood and subarachnoid area at the time of ON and contrast the findings according to long-term evolution either as intracranial neuritis or as progression to multiple sclerosis. PATIENTS AND METHODS: In a prospective investigation we searched the presence of DNA from 5 herpes viruses (HSV-1, HSV-2, VZV, EBV and HHV6) in CSF and blood lymphocytes from 54 patients with ON, patients were followed 62 ±â€¯3 months; those who developed MS were separated from those with ephemeral ON. Long-term prognosis of ON was related to DNA findings. RESULTS: As compared with controls, DNA from HSV-1 was significantly more frequent in CSF and blood from cases with ON; VZV and HSV-2 were found only in CSF; EBV was found only in blood samples (p < 0.006). CONCLUSIONS: Our results point out the potential participation of HSV, VZV and EBV in ON; suggesting the intervention of various herpes viruses as triggering agents of autoimmunity. However, the number of positive cases was minor than negative cases. Also, our results suggest that the etiological mechanisms in ON could be similar to those of neuritis of the facial nerve (Bell's palsy).

Trophic strategies of the invasive Twospot livebearer (Pseudoxiphophorus bimaculatus, Teleostei: Poeciliidae) in a gradient of environmental quality in central Mexico

Pseudoxiphophorus bimaculatus is an invasive species widely spread throughout freshwater ecosystems in central Mexico, for that reason we described its trophic strategy into a gradient of environmental quality. We sampled individuals of P. bimaculatus at eight sites located in the Lerma-Chapala and Pánuco River Basins during dry season. These basins have been impacted by industrialization and urbanization processes, but are considered as water reserves in México. To evaluate the environmental quality of the river, we applied the Visual-based Habitat Assessment, the Index of Biological Integrity and the Family-level Biotic Index. We assessed the trophic guild, the diet width, the omnivory level, and the diet selectivity. We also explored the relation of trophic strategies with the habitat condition. We captured a total of 202 individuals of P. bimaculatus from 10 to 67 mm of SL, finding a total of 24 food items. The diet of P. bimaculatus was composed of terrestrial, aquatic insects and bony fish. Pseudoxiphophorus bimaculatus in some sites can feed on different trophic levels, in other it is a specialist and secondary consumer. We found that P. bimaculatus changes its diet according the alterations in the habitat structure, water quality, and biotic integrity. Moreover, this invasive species can endure changes in the trophic web and food availability.(AU)

Pseudoxiphophorus bimaculatus es una especie invasora ampliamente propagada en los ecosistemas de agua dulce del centro de México, por eso se describe su estrategia trófica en un gradiente de calidad ambiental. Se muestrearon individuos de P. bimaculatus en ocho sitios localizados en las cuencas de los Ríos Lerma-Chapala y Pánuco durante la temporada de secas. Estas cuencas se han visto afectadas por los procesos de industrialización y urbanización, pero la Comisión Nacional del Agua las considera reservas de agua en México. Para evaluar las condiciones ambientales de las cuencas, aplicamos el Índice de Integridad Biótica basado y el Índice Biótico basado en Familias. Evaluamos el gremio trófico, la amplitud de la dieta y la selectividad de la dieta de P. bimaculatus en sitios con diferente calidad ambiental. Además, exploramos la relación de las estrategias tróficas con la condición del hábitat. Capturamos un total de 202 individuos de P. bimaculatus de 10 a 67 mm de LP, encontrando un total de 24 artículos alimenticios. La dieta de P. bimaculatus está compuesta de insectos terrestres y acuáticos y restos óseos de peces. Pseudoxiphophorus bimaculatus en algunos sitios puede alimentarse de diferentes niveles tróficos, en otros, es especialista y consumidor secundario. Encontramos que P. bimaculatus cambia su dieta acorde con alteraciones en la estructura del hábitat, la calidad del agua y la integridad biótica. Además, esta especie invasora puede tolerar cambios en la red trófica y la disponibilidad de alimento.(AU)

Iatrogenic Compartment Syndrome Secondary to Burn Dressing in a 2-Year-Old Child.

We report a severe case of compartment syndrome due to a compressive burn dressing. An otherwise healthy 2-year-old girl presented at her local health center with a superficial partial-thickness thermal burn on the dorsum of the mid phalanx of the second finger of her right hand. A compressive dressing was applied solely to the affected finger. Forty-eight hours afterward, the patient presented in the emergency room with severe pain of the finger. After removal of the dressing, a circular constrictive eschar was observed at the base of the finger, secondary to ischemia due to the compressive dressing. Emergent lateral escharotomies were performed, with immediate recovery of distal perfusion. One week afterward, the patient underwent surgical debridement of the burn on the dorsum of her finger and escharectomy of the ischemic eschar at the base. The lesions were covered with partial-thickness skin grafts. This case shows that acute compartment syndrome can lead to severe sequelae, such as the loss of an extremity or body segment. We must take utmost care in all our actions to avoid any (negligent) act that could lead to severe or permanent damage to our patients.

DPP-4 Levels Are Increased in Subjects with Poor Sleep Quality.

Background: Up to 30% of the population has sleep disturbances, generating a negative health impact, a situation that is often not known and no medical attention is sought. It has been observed that after a total deprivation of sleep, the levels of dipeptidyl peptidase 4 (DPP-4) tend to increase. The aim of this study was to compare serum levels of DPP-4 in healthy subjects, with adequate and poor-quality sleep needing medical/pharmacological treatment. Materials and Methods: Cross-sectional study of subjects scheduled for elective surgery with low cardiometabolic risk. Subjects between 18-70 years of age were included, without previous diagnosed pathology (diabetes mellitus type 2; neoplasm; nephropathy; and liver disease) and major amputations, and who signed informed consent. The study protocol was aproved in the Local Committee for Ethics and Research, number 45-16. Anthropometry was performed (% body fat; waist and neck circumferences), and sleep quality assessment (Pittsburgh Sleep Quality Index [PSQI]) to classify them as worthy or not worthy of medical/pharmacological care. Serum DPP-4 was determined by Enzime Linked Immunosorbent Assay (ELISA). The statistical analysis was done in RStudio Software. Results: Fifty seven subjects (2017-2018) were included, with a combined frequency of overweight/obesity of 66.6% and with abdominal circumference values of 93.2 ± 13.6, higher than that proposed by the International Diabetes Federation. The PSQI was 8.3 ± 4.1, and 56.1% were classified as worthy of medical/pharmacological attention. When comparing the levels of DPP-4, these were higher in this group 2385.0 ± 2082.0 versus not worthy 1716.7 ± 1261.7 pg/mL, being statistically significant (P = 0.035). Conclusions: The elevated levels of DPP-4 in person with poor quality sleep worthy of medical/pharmacological treatment could be an early indicator of metabolic disorders, which need to be evaluated in depth.

Effect of High-Energy Milling on Bioactive Compounds and Antioxidant Capacity in Nixtamalized Creole Corn Flours.

This study aimed at evaluating the effect of high-energy milling (HEM) and traditional nixtamalization (TN) on bioactive compounds and antioxidant capacity in nixtamalized creole corn flours obtained from a maize genotype cultivated under rainy temporal conditions in the Mexican semidesert. Four creole grains, including San José de Gracia white and blue (WG and BG), Negritas (NG), and Ahualulco white corn grains (SG), were used. For HEM nixtamalization, corn grains were hammer-milled; then, two different conditions were evaluated: treatment H1, with raw flours with 14% moisture content and 1.1% Ca(OH)2, and treatment H2, with raw corn flours with a 23% moisture content and 1.4% Ca(OH)2. The TN process was utilized as a control. TN recorded significant losses in luminosity value L* (p < 0.05), while HEM nixtamalized blue corn flours remained close to -b* values, that is, near to those of raw flour. Anthocyanin content showed higher content values in HEM treatments compared with TN (759.55 and 252.53 mg cyanidin 3-O-ß-D-glucoside (C3G)/kg, respectively) (p < 0.05). Total soluble phenolic content was higher in HEM nixtamalization compared with the traditional process, except for WH2 and SH2 (H2 treatment for WG and SG). Two redundant radical scavenging assays were used: antioxidant capacity (DPPH assay) exhibited less value in nixtamalized flours than in raw flour (p < 0.05). Antioxidant activity by (ABTS) assay was higher in HEM than in TN. Nixtamalized flours produced by HEM demonstrated more improvement in nutraceutical properties than those produced employing TN.

Relación entre hallazgos radiológicos e inmunofenotipos tumorales de pacientes con cáncer de mama / Relationship between radiological findings and immunophenotyped in breast cancer

Resumen OBJETIVO: Evaluar la relación entre los hallazgos radiológicos e inmunofenotipos tumorales de pacientes con cáncer de mama. MATERIALES Y MÉTODOS: Estudio observacional, retrospectivo y transversal, efectuado en el Hospital ABC de la Ciudad de México, entre 2013 y 2017. Se incluyeron pacientes con diagnóstico de cáncer de mama establecido por biopsia percutánea o escisional, que contaran con estudios de inmunohistoquímica e imagen (mastografía, ultrasonido o ambos). Para evaluar la relación entre las características morfológicas de las lesiones observadas en los estudios radiológicos y el inmunofenotipo se utilizó la prueba de χ2. RESULTADOS: Se registraron 182 pacientes. En cuanto a las características de las lesiones se encontró relación significativa entre las masas de morfología irregular con bordes espiculados y las calcificaciones agrupadas con tumores luminales, y entre las calcificaciones de morfología amorfa con los tumores luminales A y las pleomórficas finas con los tumores luminales B. CONCLUSIÓN: Existe relación entre los hallazgos morfológicos por imagen y el inmunofenotipo de los tumores mamarios. Es importante que el médico radiólogo especialista en imagen mamaria conozca esta relación, con la finalidad de proporcionar información de la inmunohistoquímica al momento del estudio diagnóstico de imagen.

Abstratc OBJECTIVE: Establish if there is a relationship between the radiological findings and the immunophenotype of breast cancer. MATERIALS AND METHODS: An observational, cross-sectional, retrospective study realized at the ABC Medical Center, over a period of 4 years, that included patients diagnosed with breast cancer performed by percutaneous or excisional biopsy, with an immunohistochemical study and images (mammography and/or ultrasound). The relationship between the morphological characteristics of the lesions observed in the radiological studies and the immunophenotyped was studied by means of the χ2 test. RESULTS: We included 182 patients, among the characteristics of the lesions we found a significant relationship between the masses of irregular morphology with spiculate edges and the calcifications grouped with luminal tumors; calcifications of amorphous morphology with luminal A and pleomorphic fine tumors with luminal B. CONCLUSION: The results suggest that there is a relationship between the morphological findings by imaging and the immunophenotype of mammary tumors.

Situación epidemiológica de malaria en la micro red Iquitos Sur, Loreto 2008-2017 / Epidemiological situation of malaria in the micro red Iquitos Sur, Loreto 2008-2017

Introducción: La malaria es una enfermedad parasitaria que ha reemergido de manera alarmante en las últimas décadas constituyendo un serio problema de salud pública a nivel mundial y nacional. La enfermedad tiene patrón endémico-epidémico, con periodos de resurgencia .Estando concentrada en la región Amazónica, principalmente Loreto, con un patrón de transmisión básicamente rural con altas tasas de infección malárica asintomática y subpatente. Análisis de la situación epidemiológica de la malaria: El distrito de San Juan cuenta con una población de 147 799 habitantes y ha reportado entre 2008 y 2017 mayor de cantidad de casos de malaria de la región Loreto, con 8 557 casos (2014). Siendo las localidades más afectadas San Juan (18,8%), Paujil (12,1%), Santa Clara (21,6), Varillal (11,9%) y Santo Tomás (8,43%) constituyendo el 72,12% de todos los casos de la Micro-red. Iquitos Sur. Siendo el grupo de edad más afectado entre los 5 a 14 años. Conclusiones: Las localidades más afectadas están ubicadas en zonas rurales o zonas cercanas a criaderos permanentes y/o temporales. La proporción del 55% de todos los casos corresponde al sexo masculino asociado a las tareas de cultivo, la pesca u otras que se desarrollan en el bosque. Las características endofilas del vector pueden relacionarse con un incremento de la IPAs entre los 5 a 14 años; y las climáticas, así como la cercanía a criaderos permanentes o temporales, como meandros, "tipishcas" y aguajales, así como las actividades productivas y la elevada densidad poblacional de aumentan el riesgo de transmisión de esta enfermedad.

Haemophilus influenzae no tipificable: mecanismo de destrucción del biofilm / Non-typeable Haemophilus influenzae: mechanism of biofilm destruction

INTRODUCCIÓN: Haemophilus influenzae tiene como hábitat el aparato respiratorio humano. No existe vacuna contra la variante no tipificable (NTHi) de este, por lo que se ha mostrado una tendencia al incremento de casos en los últimos años. La patogenicidad de NTHi se debe a su habilidad para formar biofilms, por lo que se pretende analizar mecanismos de destrucción del biofilm formado por NTHi. METODOLOGÍA: Se realizó una revisión bibliográfica mediante consultas en las bases de datos, Hinari, MEDLINE y el motor de búsqueda PubMed. Se tomaron en consideración artículos originales, ensayos clínicos y artículos de revisión bibliográfica dando prioridad a aquellos publicados en los últimos 5 años. DESARROLLO: NTHi tiene la capacidad de formar biofilms por medio de proteínas del pili y elementos estabilizadores del ADN extracelular, entre los más importantes están: DNA BII, pili tipo IV, Nucleasa extracelular 2019 y adhesinas de alto peso molecular. El uso de chalconas, EDTA y ADN como quelante de cationes, antisueros contra DNBII y maquinaria luxS más anticuerpos contra Pili IV han demostrado que pueden ser útiles para la erradicación del biofilm. CONCLUSIÓN: Se proponen dos tratamientos novedosos que podrían contribuir en la eliminación del biofilm formado por NTHi, uno es el uso de EDTA y otro los anticuerpos dirigidos a proteínas esenciales en la formación y adhesión del biofilm. Es necesario profundizar en otros estudios con estas propuestas terapéuticas para determinar su uso en el área clínica en un futuro.

INTRODUCTION: Haemophilus influenzae has the human respiratory system as habitat. There's no vaccine against the non-typeable group (NTHi), as a consequence there has been an increase in the number of cases in the past few years. The pathogenesis of NTHi is caused by its ability to form biofilms, for this reason we pretend to analyze the destruction mechanisms of biofilms formed by NTHi. METHODOLOGY: A review was made using the databases Hinari, MEDLINE and PubMed. Original articles, clinical trials and reviews that had been published in the last five years were taken in count. RESULTS: NTHi has the capacity to form biofilms through pilus proteins and extracellular DNA stabilizers; among the most important we have: DNA BII, type IV pilus, 2019 extracellular nuclease and adhesins of high molecular weight. The use of chalcone, EDTA, DNA as cation chelant, antiserum against DNA BII and luxS plus antibodies against Pili IV has shown potential to eradicate biofilms. DISCUSSION: Two new treatments, that could contribute to the removal of biofilms formed by NTHi, are proposed: one of them is the use of EDTA and the other one is the use of antibodies against essential proteins that the bacteria uses in the formation and adhesion of biofilms. Never the less, it is necessary to deepen more in studies about these therapeutic alternatives to determine their use in the clinical area in the future.

Estudio retrospectivo sobre concentración de hemoglobina y factores asociados a la anemia posparto en primigestantes menores de 30 años de Lima, Perú, 2010 / Retrospective study on concentration of hemoglobin and factors associated with postpartum anemia in primigestants younger than 30 years old of Lima, Peru, 2010

RESUMEN Introducción: el manejo del parto puede ocasionar consecuencias tanto a la madre como al recién nacido, uno de ellos es la anemia. Objetivo: Determinar la concentración de hemoglobina en el pre y posparto y factores asociados a la anemia posparto en primigestantes menores de 30 años atendidas en un hospital público de Lima, Perú. Materiales y Método: estudio descriptivo retrospectivo en 294 gestantes atendidas para su parto en el Instituto Nacional Materno Perinatal de Lima, Perú. Se consignaron las concentraciones de hemoglobina antes y después del parto, datos sociodemográficos y factores asociados. Resultados: el 67,0% de las gestantes se encontraban entre los 20 a 29 años. La mediana de hemoglobina antes del parto en las gestantes de parto vaginal fue de 12,5 g/dL y en el posparto fue de 10,6 g/ dL. En las gestantes de parto vaginal el 27,1% presentó anemia y en el posparto el 56,4%. En partos por cesárea, el 42,9% presentó anemia antes del parto y en el posparto el 78,6%. Los factores que se asociaron fueron hemorragia (ORa: 53,3 IC95% 6,6-427,2 p<0,001), trabajo de parto prolongado (ORa: 6,7 IC95% 1,5-30,1 p=0,013), rotura prematura de membranas (ORa: 2,7 IC95% 1,0-5,5 p=0,041) y desgarro perineal (ORa: 2,5 IC95% 1,0-6,1 p=0,041). Conclusiones: existe una reducción de los niveles de hemoglobina de alrededor de 1 g/dL en el posparto. Los factores asociados a anemia posparto fueron la hemorragia posparto, trabajo de parto prolongado, rotura prematura de membranas y desgarro perineal. MÉD.UIS. 2017;30(2):37-44.

ABSTRACT Introduction: the management of labor can have consequences for both the mother and the newborn, one of them is anemia. Objective: To determine hemoglobin concentration in pre and postpartum, and factors associated with postpartum anemia in primigravid woman younger than 30 years old who were attended in a public hospital in Lima, Peru. Material and Method: a retrospective, cross-sectional study in 294 postpartum primigravid woman younger than 30 years old attended in the National Institute of Perinatal and Maternal Health in Lima, Peru. Hemoglobin concentrations before and after birth, socio-demographic data and associated factors. Results: 67.0% of pregnant women were among 20 to 29 years of age. In vaginal delivery, the median hemoglobin before birth was 12.5 g/dL and postpartum was 10.6 g/dL, there was a reduction of 1.9 g/dL. In vaginal delivery, 27.1% presented anemia prepartum and 56.4% postpartum; in cesarean sections, 42.9% had anemia before delivery and 78.6% after. The factors that were associated were bleeding (ORa: 53.3 95% CI 6.6-427.2 p<0,001), prolonged labor (ORa: 6.7 95% CI 1.5-30.1 p=0,013), premature rupture of membranes ORa: 2.7 IC95% 1.0-5.5 p=0,041) and perineal tear (ORa: 2.5 IC95% 1.0-6.1 p=0,041). Conclusions: there is a reduction in hemoglobin levels of around 1g/dL of hemoglobin in the postpartum period. Factors associated with postpartum hemorrhage were postpartum haemorrhage, prolonged labor, premature rupture of membranes, and perineal tear. MÉD.UIS. 2017;30(2):37-44.

Ginecomastia: manifestaciones, etiología, abordaje diagnóstico y tratamiento / Gynecomastia: manifestations, etiology, diagnosis and treatment approach

La ginecomastia es una entidad de consulta frecuente, definida por la proliferación del tejido glandular mamario en los hombres, en la mayoría de los casos benigna y se puede presentar a cualquier edad. Debido a su etología variada y repercusiones tanto físicas como emocionales, debe realizarse un abordaje completo para descartar causas patológicas y realizar un tratamiento dirigido en los casos que lo ameritan.

Gynecomastia is a common condition defined as the proliferation of male breast glandular tissue. It is benign in most cases and it can appear at any age. Due to its distinct etiology and physical/psychologic outcomes, a complete approach must be performed to rule out pathologic causes, and to offer precise treatment.

Fisiopatología, manifestaciones sistémicas y secuelas de la fulguración en seres humanos / Pathophysiology systemic manifestations and sequelae of electrocution in humans

Un rayo es un impulso masivo de corriente unidireccional creado por un gradiente de electrones entre dos nubes o una nube y la tierra. El trauma eléctrico por lo general no es mortal, sin embargo se asocia a una serie de complicaciones médicas de importancia. Las secuelas están determinadas tanto por la intensidad de la corriente como por la duración de la aplicación energética. Las lesiones por electrofulguración ocurren por distintos mecanismos: golpe directo, lesión de contacto, “side splash”, corriente por tierra y trauma contuso. La electricidad atmosférica causa diferentes tipos de lesiones a nivel de la piel, como es el caso de las quemaduras lineales, punteadas, térmicas y en plumaje. Las figuras de Lichtenberg son patognomónicas de la electrofulguración. Además del efecto sobre el sistema tegumentario, se documentan lesiones cardiovasculares, respiratorias, gastrointestinales, oculares, auditivas y neurológicas. Cuando se presenta una muerte por electrofulguración, como pocas veces es presenciada y ocurre en espacios abiertos, se debe realizar un estudio exhaustivo del cadáver y del lugar del suceso para descartar otras causas de muerte natural o violenta. En Costa Rica en el año 2011 se presentaron 7 muertes por electrofulguración, principalmente durante la juventud y adultez temprana y a nivel de la zona rural, siendo el principal mecanismo de lesión el golpe directo.

Lightning is a massive unidirectional current that depends of an electron gradient; this electric flow travels from one cloud to another or to the ground. Electric trauma generally is not lethal, however, it is associated to several complications. Sequelae are determined both by the current strength and by the duration of the exposure. Lightning damage occurs by different mechanisms: direct strike, contact injury, side splash, ground current, and blunt trauma. Atmospheric electricity causes different skin lesions such as linear, punctate, thermal, and plumage burns. Lichtenberg figures are pathognomonic for lightning. Besides the effect on the integumentary system, respiratory, gastrointestinal, ocular, auditory, cardiovascular, and neurological injuries are documented as well. When lightning causes death, it usually happens in open places without witnesses. An exhaustive study of the cadaver and the setting of the event should be accomplished in order to exclude natural or violent causes of death. In Costa Rica in 2011, there were seven deaths related to lightning; young adults predominated and most took place in rural areas, being direct strike the main mechanism of damage.

Knowledge, attitudes, and practices of baccalaureate nursing students regarding oral health assessment.

Good oral health is important to overall health. Oral and pharyngeal cancers account for 2% of all cancers, yet no significant improvement in mortality has been demonstrated over the past 30 years. Nurses are in a unique position to integrate and conduct oral health assessments across a wide range of practice settings. Although nursing programs include health assessment and promotion in their curricula, there is poor integration of oral health as a focus. This study aimed to identify the knowledge, attitudes, and practices of baccalaureate nursing students about oral health assessment. A convenience sample of 163 students in two undergraduate courses within a baccalaureate nursing education program was surveyed. Findings indicated that these nursing students felt that oral health was essential to their nursing practice; however, they did not have a full understanding of the key components of an oral health examination or about effective smoking cessation strategies.